Multiple Sclerosis

Thoughts??

Multiple Sclerosis (MS) is an autoimmune inflammatory disorder that is caused by selective demyelination of the central nervous system (CNS) axons. The exact cause is still vastly unknown; it is believed to bd a combination of immunologic, environmental, and genetic influences. Patients present with neurological symptoms based on the location of the demyelinated lesions. Treatment usually focuses on treating MS relapses and decreasing disease progression. Many medications treat MS based on the type that is diagnosed; there are four different types. Relapsing-remitting which has stable periods and exacerbations, primary-progressive which has worsening neurological function without relapse, secondary-progressive has an initial relapse course and becomes steady with the neurological decline and clinically isolated syndrome which is usually one episode without another one for a stable period but are at risk for a flare leading to MS.

MS is a disorder that hits very close to home; my father was diagnosed with this disease in 2010 when he was 50 years old. He presented after a week without feeling in his right arm and decreased excellent motor skills resembling a stroke. He was initially diagnosed with a stroke pending an MRI, and he was out of the window for TPA, so they sent him home with an order for an MRI of the brain and spinal cord. He received his MRI and was diagnosed with MS due to many demyelinating lesions in his mind and spinal cord. He was advised to see a neurologist and received five days of 500mg IV Methylprednisolone. He regained his function in his arm, and his excellent motor skills returned. He saw his neurologist; she diagnosed him with relapsing-remitting MS, which is the most common type of MS, which is characterized by stable periods and intermittent acute exacerbations, and she placed him on Tysabri. Tysabri treats the myoclonal antibodies that attack the healthy cells in the brain, which leads to demyelination lesions.

MS is debilitating; it carries many symptoms that can cripple a patient and family. My father has many issues with significant fatigue. Still, many patients suffer from optic neuritis, diplopia, trigeminal neuralgia, facial sensory loss, cerebellar ataxia, nystagmus, urinary urge incontinence, constipation, or erectile dysfunction. These are extremely hard on the patients and their families; my dad’s ability to be productive is now gone. He worked for most of his life, and now he cannot. He was very depressed, almost suicidal at times; he had to be on medication that has many side effects. His whole life changed, and he had to realize his limits, or he would tire out and physically could not keep his eyes open.

 

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